IMPROVING EMPLOYEE HEALTH, WELLBEING & ATTENDANCE

Trust Policy and Procedure Document ref. no: PP(15)036 IMPROVING EMPLOYEE HEALTH, WELLBEING & ATTENDANCE For use in: For use by: For use for: Document Owner: Status: All areas of Trust All Trust Employees. Managing attendance Executive Director of Workforce & Communications Approved Purpose of this Document: To provide guidance to managers and supervisors on improving attendance, the monitoring and management of attendance, and provide a standard across the Trust to ensure that attendance is managed in an equitable, consistent and sensitive way. To provide managers and supervisors with clear guidance on the support available from Occupational Health and Human Resources to help manage attendance. To give all staff clear guidance on the sickness absence reporting process and how both short term and long term sickness absences will be managed. To outline the Trust s commitment to the health and wellbeing of all staff. Contents Pages 1 Introduction 2 2 Principles 3 3 Work Life Balance, Employee Welfare & Healthy Workplace 4 4 Improving Attendance 4 5 Sickness Absence Notification Process 5 6 Fit Notes 7 7 Annual Leave & Sickness 7 8 Sickness Absence Pay Entitlement 8 9 Bradford Factors 9 10 Return to Work Interviews 9 11. Short Term Sickness Absence 10 12. Formal Attendance Reviews 11 13. Long Term Sickness Absence 13 14. Occupational Health Department 15 15. Phased Return to Work 16 16 Temporary Adjustment of Duties and Hours 16 17 Case Conference 16 18. Redeployment 17 19. Long Term Sickness - Final Review 17 20. Termination of Employment on Grounds of Ill-Health 18 Incapacity Due to Ill Health 21 Role of the HR Department 18 22 Review & Monitoring 18 23 Document Configuration 19 Issue Date: October 2015 Review date: October 2017 Page 1 of 19

1. INTRODUCTION 1.1 The Trust s Human Resource strategy aims to ensure that all employees are able to make the best possible contribution, individually and collectively, to improving health and patient care. The Trust is committed to improving the quality of working life for employees. Ensuring a good work/ life balance and reducing sickness absence rates is an integral part of creating a healthier workplace. All managers must support employees to improve their attendance and create a healthier workplace; they must ensure that the employees for whom they are responsible for are: aware of the wider organisation aware of what they are contributing to the organisation given the ability to provide real impact into the way they perform their tasks communicated with on all issues that affect them and the organisation provided with the best possible working environment 1.2 The Trust provides a range of health and wellbeing initiatives to all employees as these can have a positive effect on attendance, productivity and employee engagement. This supports one of the staff pledges in the NHS Constitution to provide support and opportunities for staff to maintain their health, wellbeing and safety. It also supports the 4 key facets of quality, innovations, productivity and prevention (QIPP) and will contribute to the success of the organisation. The Trust provides all staff with access to Care First a free, confidential 24/7 advice, information and counselling service. Further information is available from HR or Occupational Health. 1.3 The Trust ensures that the necessary attention is paid to the Health and Safety of its employees. Where absence due to ill health exists, employees are treated as individuals and their needs and circumstances are taken into account. Whenever the subject of attendance is raised employees should be made aware of the benefits to the Trust of high levels of attendance and the effect it has on the morale of fellow employees and the service to the patients. 1.4 All employees and prospective employees of the Trust will be made aware of their responsibility to ensure that they make every effort to maintain their fitness and availability for work. 1.5 Sickness absence that is not managed appropriately is not only costly but can also cause loss of dignity and self-esteem for the individual as well as problems of a reduced service and loss of motivation within the department. Those most affected by absence are often employees who have to cover for their colleagues. 1.6 Wherever this policy refers to absence it is only in relation to absence due to ill health. Issue Date: October 2015 Review date: October 2017 Page 2 of 19

2. PRINCIPLES 2.1 The Trust offers a range of health and wellbeing initiatives which are detailed on the intranet site and regularly advertised in the Green Sheet. 2.2 The Trust has a commitment to act as a reasonable employer at all times in its dealings with employees who suffer illness or incapacity, whether temporary or permanent. 2.3 The Trust is committed to ensure that every reasonable effort is made when an employee becomes disabled to enable them to remain in employment (see Policy PP()077 - Recruitment and Retention of People with Disabilities). 2.4 It is the responsibility of managers to monitor all attendance levels and causes of sickness absence within their own area. The HR Department is available for advice and support for all absence situations including referrals to the Occupational Health Department. 2.5 Support and communication should be maintained between the manager and the employee who is absent due to sickness, and the employee should not return to work until advised fit to do so. 2.6 Any employee on long-term sick leave (> 4 weeks) should see Occupational Health before returning to work. The manager will therefore need to refer employees who have been certified off sick, or whose overall attendance patterns are of concern. 2.7 All employees should receive a return to work interview with their supervisor/manager following every period of sickness. This shows support is being offered and attendance is actively being monitored. This interview may be held over the telephone, if the employee s main place of work differs from their manager. Employees can be accompanied by either a union representative or colleague not acting in legal capacity acting in a non-legal capacity. 2.8 If sickness becomes particularly high within a specific Department/ Directorate a detailed plan of action should be drawn up in consultation with the HR Department. This should include preventative measures (e.g. Moving and Handling assessments/training), close monitoring of attendance levels, raising awareness and active management of problem areas. 2.9 When attempting to resolve issues relating to attendance problems, managers must be as flexible as is reasonably practicable within the demands of the service. Consider flexible working patterns, hours of work and making reasonable adjustments to reach a speedy resolution. A manager does not have to create a post, but should review the needs of the post and the service. Consideration should be given as to whether an arrangement is for a short or long-term period and this needs to be monitored accordingly. The HR Department is available for help and advice. 2.10 Other than in exceptional circumstances, employees who have an unacceptable attendance level shall not work bank shifts or overtime until they are fulfilling their contracted hours. 2.11 Any sickness absence that is suspected not to be genuine will be referred to the Local Counter Fraud Officer for investigation. Issue Date: October 2015 Review date: October 2017 Page 3 of 19

3. WORK LIFE BALANCE, EMPLOYEE WELFARE & HEALTHY WORKPLACE 3.1 The Trust provides a working environment that supports employees and respects the need for a healthy and productive balance between work and life outside work whilst recognising that the NHS is a 24/7 service. 3.2 The Trust operates a Smoke Free Environment Policy PP()004 across the site including buildings and grounds. A Smoking Cessation Officer is available to support staff to give up smoking. 4. IMPROVING ATTENDANCE 4.1 Responsibilities at Recruitment In accordance with the Recruitment & Selection Policy PP()049 it is essential that pre and post employments checks are carried out to ensure a safe recruitment decision is made, including the completion of a Declaration of Health Form. Where there are concerns relating to the candidate's previous attendance record and their ability to attend on a regular basis, managers should refer the candidate back to Occupational Health for a more detailed assessment. 4.2 Failure to disclose sickness absence at Recruitment stage The Trust has the right to revoke a conditional offer of employment where a candidate has failed to disclose to Occupational Health an accurate sickness absence history for the previous two years. If an on-going health issue is identified at a later date that had not been disclosed, or has been misrepresented at the recruitment stage the Trust has the right to invoke the Trust's Disciplinary Policy. This process may result in the employee being summarily dismissed (dismissed without notice) on the grounds of gross misconduct. See Recruitment & Selection Policy PP()049 and Disciplinary Policy and Procedure PP()053. 4.3 Induction All employees must be made aware of the Improving Employee Health, Wellbeing & Attendance policy and in particular the procedure for reporting sickness absence during their local induction. They should be advised which policies they must read and where these can be located. It should be recorded on the local induction record that this topic has been covered in detail. Employees should also be made aware of the impact sickness absence has on the service provided to the patients. All managers involved in the management of attendance should attend the Skills Plus training session on Managing Employee Attendance. Issue Date: October 2015 Review date: October 2017 Page 4 of 19

4.4 Attendance at meetings Where an employee is absent from work due to sickness and is required to attend a meeting with their manager, they should make every effort to attend. Occupational Health will assist in assessing whether the employee is medically fit to attend a meeting with their manager. In certain circumstances, where an employee is medically unable to attend a meeting at the West Suffolk Hospital, managers may consider holding meetings elsewhere depending on the employee's medical fitness i.e. at the employee's home or at an offsite neutral setting. 5. SICKNESS ABSENCE NOTIFICATION PROCESS 5.1 Initial Notification All employees should advise their manager or an agreed nominated person as soon as they know they will be absent from work by telephone, and they should record who they spoke to. Cover arrangements may have to be made and therefore maximum notice is essential, and at a minimum at least one hour before the start of the shift. Persistent failure to follow the correct reporting procedures may result in disciplinary action being taken in accordance with the Trust's Disciplinary Policy and Procedure. Employees should not report their absence to colleagues rather than a manager or supervisor and should never just leave a telephone message or send a text message, email or use social media. Notification should always be made by the employee or in exceptional circumstances by a relative or friend. Employees should advise their manager of the nature of illness and the expected length of absence. Employees involved with the handling of food should refer to the Food Hygiene Policy PP()154 If it is not possible to give a clear idea on the likely duration of the absence the employee must keep in regular contact with their manager so that cover can be arranged. Failure to notify the Trust in accordance with the provisions of this policy may result in the absence being unauthorised, and as a result the absence may be unpaid. All sickness absences must be recorded on Healthroster or the Sickness Absence Forms so that the information can be reported to Payroll. Unauthorised absence will be dealt with under the Trust's Disciplinary Policy and Procedure. 5.2 Continued Absence It is a reasonable expectation that employees absent from work due to sickness keep their manager informed of their progress and proposed return date. It is also reasonable that a manager should keep in contact with an employee who is off sick to offer support. The employee should contact their manager as follows:- Issue Date: October 2015 Review date: October 2017 Page 5 of 19

Day 1 To advise of illness and expected duration (if possible). If only likely to be 1 or 2 days the employee will need to complete a Self-Certificate Form from the first day of absence as soon as they return to work. Failure to notify the Trust on Day 1 may result in the absence being unauthorised and as such, the absence may be unpaid. Day 3 To advise whether returning to work on Day 4; if not, the manager will forward a Self-Certificate Form for completion by the employee. This form must be completed from the first day of absence. Failure to contact the manager on Day 3 may result in the manager making contact with the employee to discuss current absence. Day 7 To advise of return to work, if not the employee must provide a GP Fit Note to cover the on-going period of absence. Failure to contact the manager on Day 7 may result in the manager making contact with the employee to discuss current absence. Reasonable contact should be made before any Fit Note expires to advise the manager of continued absence due to illness or expected date of return to work. If the employee does not contact their manager, the manager may contact the employee as above. It is reasonable for managers to continue to contact staff on long term sickness absence on a regular basis, e.g. fortnightly. For periods of long term sickness the employee should keep their Manager informed of their progress on a regular basis. Where an employee has been absent due to sickness for four weeks, the manager will advise the HR Department and discuss the appropriate action to be taken and support to be offered. The Payroll Department will advise the employee and the manager in writing when the entitlement to sick pay will reduce to half pay and to zero pay. 5.3 Reporting back from sickness absence It is essential that all staff report back from sickness on the first day that they are no longer sick, even if this is not a day that they are scheduled to work. All employees annual salaries are divided by 365 and therefore employees are paid for every day of the year regardless of whether it is a day they actually work. In addition, should a MAJAX be declared, it is essential that the Trust is aware of which staff are fit for work, even if they are not rostered to be working, as it may be necessary to call staff into work. Failure to report back from sickness absence may mean that the absence is recorded in excess of the actual period of absence and this will affect the Bradford Factor (See Section 9) Issue Date: October 2015 Review date: October 2017 Page 6 of 19

6. FIT NOTES Fit Note is the informal name for the Statement of Fitness for Work. From 6 th April 2010, the Fit Note replaced the Sick Note (medical statement or doctor s note). Fit notes are issued by doctors to state an employee is either: Unfit to work Fit to work Fit to work with adjustments. As doctors do not have full information regarding the employee s role, where an employee is certified as fit to work with adjustments, Occupational Health will assess the employee s ability to return to work or undertake a phased return and will inform the manager of their recommendation. In exceptional cases, the Trust may require employees to provide medical certificates for every period of sickness absence (including whilst on annual leave). The circumstances when this may be appropriate are: Regular absences of less than 8 days, which are not reducing sufficiently over time. Concern that there may be an underlying health problem, which the employee has not brought to the attention of their GP. If the GP requires payment for certificates of sickness of less than 8 days duration, the cost will be met by the department/directorate (with the exception of certificates used to claim back annual leave). 7. ANNUAL LEAVE AND SICKNESS 7.1 Sickness whilst on booked annual leave If an employee is sick during annual leave it may be possible to claim back that period of leave. The purpose of this benefit is to allow an employee who due to sickness/accident has not been able to take their booked annual leave i.e. hospitalisation/incapacitation and subsequently had to cancel a holiday. To qualify the employee must produce a Fit Note to cover the leave period and must also have contacted their manager on the first day of the sickness to inform them that they are unfit for work in accordance with Section 5. 7.2 Sickness on a Bank Holiday Employees who report sick on a bank holiday will not be entitled to reclaim that days leave. 7.3 Sickness whilst Abroad Employees taken ill whilst abroad will be required to follow the same procedure as detailed in Section 7.1 to be able to reclaim any part of the leave back. Issue Date: October 2015 Review date: October 2017 Page 7 of 19

7.4 Carry over of Annual Leave following long term sickness absence Where an employee on long term sick leave is unable to take their accrued annual leave before the end of the leave year, because they have been unfit to work, the employee is permitted to carry forward their accrued but untaken annual leave. This will be limited to a maximum of 20 days (pro rata for part time employees) in accordance with the Working Time Directive). An employee on sick leave should be permitted to take their annual leave, if they wish, at any time during the period of sick leave. It is acceptable for managers to encourage employees to take their annual leave entitlement in before the relevant leave year in which it accrues comes to an end and a new annual leave year commences. The employee needs to request in writing to their manager (copy to HR) any annual leave period to be taken during sickness absence in the usual way. There is no requirement for any change to the Fit Note covering the period of sickness absence. The Trust will record the relevant period of sickness and annual leave in the usual way to ensure the employee s records are accurate. 8. SICKNESS ABSENCE PAY ENTITLEMENT In normal circumstances, when an employee is off sick they will receive occupational sick pay (OSP) in accordance with Section 14 of the Agenda for Change Terms and Conditions. The entitlement to full pay and half pay is calculated based on continuous NHS Service. Where an employee has completed a 4 week phased return but is not achieving their full contractual hours, they will only receive pay for the hours they have worked. Employees will be able to use annual leave in these circumstances to make their week up to their normal contracted hours. For the purposes of calculating sick pay, no account will be taken of injuries or diseases sustained by the employee in the discharge of their duties, through no fault of their own e.g. contracting measles, chickenpox etc. from a patient or sustaining an injury whilst lifting and handling a patient using the correct manual handling procedure. However, these episodes will be included in the calculation of the Bradford Factor calculations when reviewing overall levels of absence. Managers should be aware that sick pay is not normally payable for absence caused by an accident due to an active participation in sport as a profession to where contributable negligence is proved. 8.1 Injury Allowance (I.A.) If an employee sustains an injury/disease at work as a direct result of carrying out their duties they may be eligible to claim I.A. In order to support such a claim it is essential that an incident form is completed/ that the incident is recorded on the Datix system at the time. It is also possible that an employee may be eligible for Injury Benefits from the Department of Work and Pensions (application for this should be made directly to the DWP). Issue Date: October 2015 Review date: October 2017 Page 8 of 19

9. BRADFORD FACTOR The Bradford Factor is a tool designed to help managers to monitor attendance. It is not a precise measurement and should be used along with other information when assessing attendance. An employee s irregularity of attendance can be assessed by combining measures of absence frequency and duration. The scores show whether an individual s absence record is made up of a few, or many, occasions of short or long periods. It can be used to monitor trends in absence and to provide trigger points. The basic formula is: S x S x D S = The number of spells (occasions) of absence in a specified period D = The number of days of absence in that period 1 occasion of 12 days, Bradford Factor = 1x1x12 = 12 6 occasions of 2 days each, Bradford Factor = 6x6x12 = 432 12 occasions of one day each, Bradford Factor = 12x12x12 = 1728 Monthly Bradford Factor reports will be produced by the HR Team and sent to the appropriate managers. Managers undertaking formal absence monitoring interviews can obtain individual absence reports from the HR Team. General Managers will also receive a monthly update on sickness absence figures for their Divisions. The Trust has identified a trigger point for managers to instigate formal attendance monitoring for all employees; this is a Bradford Factor score of over 100 in a full six month reporting period. Managers should also monitor a twelve month Bradford Factor and have the right to undertake a sickness review if there are other indications or issues that are identified, i.e. patterns in sickness absence. 10. RETURN TO WORK INTERVIEWS Every employee must have a return to work interview with their manager or supervisor at the earliest opportunity after every episode of sickness absence. This interview should be informal and the employee should be advised that it is normal practice. The content of this meeting will depend on the circumstances of the case e.g. previous attendance record, nature of the illness etc and should be used to ascertain:- Whether the employee is fit to return to work. The current Bradford Factor score and any patterns in the employees sickness absence Whether there is a requirement for a formal attendance meeting to be arranged. Issue Date: October 2015 Review date: October 2017 Page 9 of 19

Whether there are any underlying causes for the sickness absence (either domestic or work related.) Whether any action can be taken to eliminate future possible absence. A written record of the interview should be made and signed by both the manager and employee. 11. SHORT TERM SICKNESS ABSENCE This is defined as frequent periods of absence over a period of time, certified and uncertified. Short term is classed as any one occasion of sickness lasting less than four weeks. Recurrent short-term absences may be attributed to one or more self-limiting illnesses or a recurrent underlying health problem. Managers will be required to monitor episodes of sickness absence as well as total working days lost due to sickness. 11.1 Managing Short Term Absences It is essential that managers closely manage short term absences as these may have a greater detrimental effect on the quality of patient care than long term absence. Every employee who reaches the Bradford Factor trigger point of 100 over a full six month reporting period or where any patterns/trends relating to sickness absence are identified will be required to attend a Stage 1 meeting (see Section 12). Attendance meetings are not disciplinary in nature and health problems should be treated as a capability issue. However, continued regular short-term absences showing no underlying health problem as determined by Occupational Health, and which have failed to improve following a Stage 1 Attendance meeting may be managed under the Disciplinary Policy and Procedure as a performance issue, if appropriate. Where an employee attends work and then goes off sick before the end of their shift, they are required to have worked 50% of their shift; otherwise it will be classed as a day s sickness for the purpose of calculating the Bradford Factor. 11.2 The Aims of Managing Short Term Absences To reduce the levels of short term sickness absence in the department/ward and thus improve patient care and staff wellbeing. To reinforce the correct sickness absence reporting process. All employees attendance should be effectively monitored and all decisions based on known facts. Issue Date: October 2015 Review date: October 2017 Page 10 of 19

Every employee who has frequent periods of absence should be made aware of the effect their absence has on their colleagues, patients and the organisation. To enable managers to deal appropriately where an employee s level of attendance is unacceptable. To ensure that employees are given support and guidance with problems in the workplace or domestic situations. To ensure all employees are aware of the Special Leave Policy PP()066 for Domestic, Personal and Family Reasons, and that sickness absence should only be taken for personal sickness and not family illness. To ensure that each employee with an unacceptable level of attendance is aware of the action which could be taken against them if there is no improvement; i.e. this could ultimately lead to termination of employment on the grounds of incapacity. 12. FORMAL ATTENDANCE REVIEWS 12.1 Stage 1 Meeting Managers will arrange to meet formally with any employees who have reached a Bradford Factor of 100 in the previous full six month period or where specific sickness absence patterns are identified. This will be to establish: a) If there are any underlying health problems which initially the manager or Occupational Health may be able to assess and assist with; and b) To ensure that employees are aware of their own levels of attendance and those of the department/directorate. c) The first of such meetings will be formal and it is good practice to involve an HR Advisor. Employees are entitled to be accompanied at the meeting by a union representative or colleague acting in a nonlegal capacity; therefore they must be given reasonable advance notice of the meeting 12.2 Stage 1 Attendance Improvement Notice A written record of the meeting in the form of an Attendance Improvement Notice will be sent by the manager to state the required improvement and any agreed support. A copy should be placed on the employee s personal file. This letter should include a review date, which depending on circumstances should be between one month and three months, with a minimum of two review meetings during the six month period. The Attendance Improvement Notice will remain in place for six months. If an HR Advisor was not in attendance at the meeting, a copy of the letter should be e-mailed to The Absence Management Team. Issue Date: October 2015 Review date: October 2017 Page 11 of 19

Further Action Whilst the six month notice is in place the manager should continue to formally monitor the employee s attendance. If attendance throughout the six month period is maintained at a satisfactory level then the formal monitoring will cease at the end of the Attendance Improvement Notice period and the Notice will be considered spent. However, if the employee s absence level does not improve or does not reduce below 100 the manager will have the option to re-issue/extend or move to a Stage 2 meeting. Failure to Maintain Satisfactory Attendance after an Attendance Improvement Notice has been spent. During the six month period immediately after the notice has been spent, if the employee s Bradford Factor returns to a score of 100 or above then the manager will meet with the employee to either reissue a Stage 1 Attendance Improvement Notice or move to a Stage 2 meeting. For purposes of consistency, this will be in discussion with HR. 12.3 Stage 2 Meeting This is a formal meeting and the employee should be advised of their right to be accompanied by a union representative or colleague acting in a non-legal capacity. An HR Manager or HR Advisor will also be in attendance. The meeting should be identified as a Stage 2 Attendance Meeting and any supporting information, which will be discussed, will be sent to the employee in advance of the meeting. In the attendance meeting, individual and departmental levels of absence should be discussed together with any additional information which may be available (e.g. from Occupational Health) and where appropriate, an agreement reached about the improvement expected, timeframe for this improvement and what support will be provided. 12.4 Stage 2 Warning A written record of the meeting in the form of letter will be sent to the employee, stating the required improvement and any agreed support with a copy placed on the personal file. This should include a review date, which depending on circumstances should be between one month and three months with a minimum of two review meetings during the six month period. The warning will remain in place for six months. During the absence meeting the employee must be made aware of the implications if they are unable to meet the terms of their contract and that dismissal on grounds of incapacity will result if improvement is not made. Advice should be sought from a HR Manager/Advisor on these matters Issue Date: October 2015 Review date: October 2017 Page 12 of 19

Further Action Whilst the six month warning is in place the manager should continue to formally monitor the employee s attendance. If attendance throughout the six month warning is maintained at a satisfactory level then the formal monitoring will cease at the end of the warning period and the warning will be considered spent. It is also important, where appropriate, to discuss at this stage redeployment and rehabilitation possibilities including reduction in hours, and any necessary advice sought from Occupational Health, including whether any condition falls within the definition of disability under the Equality Act 2010 (incorporating the Disability Discrimination Act 1995) However, if the employee s absence level does not improve the manager will move to a Final Attendance Hearing. Failure to Maintain Satisfactory Attendance after a Warning has been spent. During the six month period immediately after the warning has been spent, if the employees Bradford Factor returns to a score of 100 or above then the manager may move to a Final Attendance Hearing. 12.7 Final Attendance Hearing (Potential Dismissal) If after the issue of a Stage 2 Warning, if it is established that improvement has not been made within the agreed timescale, or following an initial improvement attendance levels have again deteriorated, a Final Attendance Hearing will be arranged. The employee's manager, a Dismissing Officer and a Human Resources Manager/Human Resources Advisor must attend. The Dismissing Officer will hear the evidence and make a decision on whether or not dismissal is appropriate and on what grounds. The employee is entitled to be supported at this meeting:- The employee must be given reasonable advance written notice of the Final Attendance Hearing. They must be advised of their right to be accompanied by a union representative or colleague acting in a non-legal capacity They must be provided with any relevant information/statements. They must be made aware in advance that one possible outcome of the meeting is dismissal. Dismissal in these circumstances will be with notice, or pay in lieu of notice, where applicable. 12.8 Appeal The employee will have the right of appeal to a Sub Committee of the Trust Board against the decision to dismiss them. The appeal will be heard in accordance with the procedure laid out in the Trust Disciplinary Policy and Procedure. Issue Date: October 2015 Review date: October 2017 Page 13 of 19

13. LONG TERM SICKNESS ABSENCE This is classed as any one continuous episode of sickness absence usually linked to an on-going medical condition. 13.1 Managing Long Term Sickness Absence The timescale for monitoring long term sickness absence will depend on the nature of the illness. Any employee absent due to sickness for more than four weeks should be referred to Occupational Health for advice and access to appropriate interventions/treatment where possible. Managers should keep in regular contact with the employee and hold regular review meetings to provide support and identify any possible interventions or treatment that the Trust could offer. At a minimum there should be contact at least once a month. Employees may be accompanied to these meetings by a union representative or a work colleague acting in a non-legal capacity, managers should be supported by an HR Advisor. The Bradford Factor score should still be used to identify high levels of absence but individual circumstances should be considered before attendance warnings are issued. In some cases such as mental health illness or physical injury, the employee may find it difficult to attend meetings in the work place. In these circumstances managers should consider offering either to hold the meeting at the employee s home or at an offsite neutral setting. 13.2 Managing Serious Illness There will unfortunately be occasions where employees are diagnosed with a serious and possibly life threatening health condition. Under these circumstances it is not appropriate to issue Attendance Warnings as detailed in Section 12 - Formal Attendance Reviews. However, it is important that managers still manage the absence and offer the employee appropriate support. It is essential that good communication is maintained between the manager and the employee. Managers need to be aware, particularly in cases of chronic or terminal illness, that employees could be distressed to a high degree and therefore must be dealt with sympathetically and with due consideration for their condition. It may be necessary to have difficult discussions with the employee regarding the likelihood of them ever being fit to return to work or accessing their NHS Pension and advice and support should always be sought from the HR Department and Occupational Health. Issue Date: October 2015 Review date: October 2017 Page 14 of 19

13.3 The Aims of Managing Long Term Absence To offer support and advice to the employee and to gain an on-going understanding of the nature and likely duration of the absence. To keep in regular contact with the employee to prevent them from becoming isolated from work and their colleagues. To assist with the planning of cover arrangements whilst the employee is absent. To facilitate a reasonable return to work date for the employee and to identify any training updates that may be necessary. To identify where an employee is unlikely to be able to return to their contracted post and consider alternative options. 14. OCCUPATIONAL HEALTH DEPARTMENT 14.1 Referrals When referring an employee to the Occupational Health Department, it is important to ensure that the employee understands the reason for referral and the positive contribution the Occupational Health Service can make in terms of support and advice. In any appropriate circumstance, a manager may require an employee to attend an examination by a medical practitioner. This is a reasonable management instruction. Medical assessments will normally be carried out by Occupational Health, but there will be occasions when they need to refer to a specialist practitioner or liaise with the employees GP. For the latter, the Occupational Health team will require written consent from the employee. In conjunction with Occupational Health, the manager should seek to identify (where appropriate) interventions and treatment that could support a return to work at the earliest opportunity, for example physiotherapy or professional counselling. An employee does not have to be off sick to consider appropriate interventions that could assist the employee to remain at work or improve their attendance. 14.2 The Role of the Occupational Health Service The Occupational Health Service will support the employee throughout their absence and advise their manager, HR and the employee on possible courses of action. This advice will be based on their knowledge of the illness and the employee's job. Where appropriate, the Occupational Health Department will also seek the opinion of the employee s GP or Specialist Consultant, It is not always possible for these decisions to be made at the start of the period of absence. Therefore review may be necessary before a response can be given by the Occupational Health Service. Managers should be aware that the Occupational Health Department opinions and actions are governed by their Confidentiality Code of Practice. Issue Date: October 2015 Review date: October 2017 Page 15 of 19

14.3 Night Working Service Requirement Where Occupational Health have assessed an employee as being fit to work, but not fit to undertake night duty and this is a requirement of their contract of employment and needs of the service, the Trust reserve the right to consider alternative employment for that employee until such time as they can fulfil their original terms and conditions. If this cannot be secured within a reasonable period of time and subject to the duty to consider reasonable adjustments, the Trust shall consider termination of their statement of contract on the grounds of incapacity due to ill health. Occupational Health will review any employee exempt from night working on a six monthly basis. 15. PHASED RETURN TO WORK On occasion and where appropriate some employees will be offered a phased return to work following a period of long term absence. The purpose of a phased return is to support the employee to return to full duties and full contractual hours. Before an employee returns from long term sickness absence the manager will refer them to Occupational Health who will consider and give guidance to the manager on what hours and duties are appropriate for the individual employee. Occupational Health will make a recommendation regarding the number of hours the employee is able to work. This must be done in association with the employee s line manager in order to ensure it meets the needs of the service. Occupational Health will then issue the notification directly to the manager via email with copies to the Service Manager. It is the manager s responsibility to determine whether or not they can accommodate the suggested hours and duties; if they are unable to accommodate the recommendations they should discuss the matter directly with Occupational Health. In addition, Occupational Health will advise the employee s line manager regarding the pace of increase in hours by undertaking regular reviews. Typically, a phased return should not exceed 4 weeks and a case conference should be arranged if it is likely that the phased return will exceed 6 weeks. Ultimately the manager has the final decision on whether the phased return is viable. 16. TEMPORARY ADJUSTMENT OF DUTIES AND HOURS In some situations it may be possible to support the employee to return to work at the earliest possible time by making a temporary adjustment to their duties and/or hours, [including a temporary transfer to an alternative area where the duties are lighter and/or less stressful] These situations must be agreed between Occupational Health, HR, the manager and the employee, where there is a benefit to the employee returning to work in some capacity but this temporary arrangement should not continue for more than 6 weeks. Issue Date: October 2015 Review date: October 2017 Page 16 of 19

17. CASE CONFERENCE If the employee does not achieve full duties and full contractual hours within an initial phased return period the manager should arrange a Case Conference. A record of this discussion should be made and kept by the manager. The purpose of the Case Conference is to decide whether the employee is likely to return to full duties/hours within an acceptable time frame, and if not the following options should be considered: Permanent reduction in contracted hours Redeployment to suitable alternative employment Ill-health retirement Termination of their statement of contract on the grounds of incapacity due to ill health. HR advice should be sought on the appropriate attendees at the case conference. All employees should be advised that they have the right to be accompanied by a union representative or a work colleague acting in a non-legal capacity. 18. REDEPLOYMENT Where the employee is diagnosed as being incapable of returning to their contractual duties in their current post for the foreseeable future, efforts to obtain suitable alternative posts within the Trust should be made in accordance with the Trusts Recruitment & Selection Policy PP()049 and comply with the duty laid out in the Equality Act 2010. The Equality Act 2010 requires employers to make reasonable adjustments to a job in order that an employee with a disability can continue to carry out that role. This can be an adjustment to the post that the employee currently holds or a post that could offer redeployment. Where adjustments are being considered, advice should be sought from Human Resources and Occupational Health. The Trust does not have to create a post for an employee in a redeployment situation. Employees, who are seeking redeployment and meet the basic personal specification for a post, should be offered an interview without competition. Redeployment into a lower Pay Band will not be eligible for Pay Protection. If, at any stage, it is identified that the job the employee performs directly affects their health, transfer/redeployment to more appropriate duties will be considered. Where steps are being taken to redeploy an employee, the employee will be made aware that if no suitable employment is identified within a reasonable period the contract of employment may be terminated on ill-health grounds. Issue Date: October 2015 Review date: October 2017 Page 17 of 19

19. LONG TERM SICKNESS - FINAL REVIEW Managers should seek to conclude the review process before an employee has been absent for a period of 12 months. In circumstances where an employee is entitled to the maximum entitlement of six months full pay and six months half pay, a clear course of action should be agreed at least four months before the employee s entitlement ceases. Where the employee s entitlement is below the maximum, decisions will need to be made earlier. All employees are entitled to be supported by either a union representative or a work colleague acting in a non-legal capacity. 20. TERMINATION OF EMPLOYMENT on the grounds of incapacity due to ill health. If after taking medical advice the manager is told that the individual s condition renders them unfit to continue working in their post for the foreseeable future and there are no redeployment opportunities, then they will have no alternative but to terminate the employee s statement of contract on the grounds of incapacity due to ill health. The case must be considered by a senior manager with the authority to dismiss. In these circumstances the Trust will have the option to terminate the contract of employment before the employee has reached the end of the contractual sick pay absence period. The employee s notice will be paid to them along with any accrued annual leave. 20.1 Application for the early release of NHS pension If the employee pays superannuation they may be eligible for early release of their NHS Pension and the application should be made through the Pensions Officer (please note acceptance of an application for Ill Health retirement is totally at the discretion of the NHS Pensions Agency and five months notice is usually required). Successful applications can be agreed as either:- Tier One The employee has been assessed as not fit to undertake their substantive role and the Trust has not been able to find redeployment, but the Pensions Agency believe that the employee is fit to undertake some kind of work elsewhere. In these circumstances the pension is paid at a lower rate. Tier Two The Pensions Agency has assessed the employee as unfit to undertake any kind of work and therefore the pension is paid at a higher rate. Issue Date: October 2015 Review date: October 2017 Page 18 of 19

21. ROLE OF THE HR DEPARTMENT No two cases of absence are the same and managers are encouraged to contact Human Resources for advice and support at any time. Where possible, HR will always provide experienced support at all attendance meetings. The role of the HR representative is to ensure that there is a full and thorough discussion of the issues, that the procedure has been applied properly, fairly and consistently and to ensure that any action taken by the manager is fair and reasonable in the circumstances. 22. REVIEW & MONITORING This Policy and Procedure will be reviewed annually by the Executive Director of Workforce & Communications in conjunction with the Trust Council. 23. DOCUMENT CONFIGURATION Author(s): Angie Manning, HR Manager, Claire Scott, HR Manager Other contributors: Liz Houghton, Deputy Director of HR & Communications Approvals and endorsements: Trust Council Consultation: Trust Council Issue no: 6 File name: CharlieS/Personnel/draft policies/improving Employee Attendance Supersedes: PP(14)036 Equality Assessed Yes form completed Implementation Policies will be distributed by the IG Manager to General Managers, Service Managers and all Ward/Department Managers. Policy will be available on the Trust Intranet Site. Monitoring: (give brief details how this Implementation, compliance and effectiveness of this policy will be will be done) monitored by the HR & Communications Directorate on an on-going basis. This will be achieved by monitoring the sickness absence rates for the Trust as a whole and for individual employees. Quarterly attendance figures are issued by OH to the budget holders. All employees whose Bradford Factor exceeds 100 over 6 months will be formally monitored Other relevant policies/documents & references: by the Line Manager. Department of Health: Managing Ill-Health Retirement in the NHS. Department of Health: Managing Sickness Absence in the NHS. Cabinet Office: Managing Attendance in the Public Sector: Putting Best Practice to Work. Issue Date: October 2015 Review date: October 2017 Page 19 of 19